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1. ACTS Learning Health System (LHS) Cycle


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2.More detailed ACTS current/future state LHS/Knowledge Ecosystem Cycle

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3. The diagram below is part of a slide deck prepared for ACTS by Per Olav Vandvik and Linn Brandt from the MAGIC Evidence Ecosystem Foundation 

ACTS Coordination in the center, surrounded by an ecosystem of organizations and initiatives working together.Image Modified

  Full deck is here: from MAGIC - Solutions Evidence Ecosystem for ACTS October 28 2019 (2).pptx (see Assistive Technology Disclaimer).

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4. Quality Ecosystem - FHIR Standards (Maria Michaels version)

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5. Brian Alper/COKA FHIR Diagrams

Coordination and support in the center, surrounded by elements of the evidence ecosystem working together.Image Modified                                                   

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Alper/COKA also working graphic "Computerized Organization to Realize Ecosystem": "The slices of the circle are DATA to EVIDENCE to GUIDANCE to ACTION. The layers from the outer ring to the core show each slice from GENERAL to SPECIFIC to COMPUTABLE to EXECUTABLE. The closer to executable, the closer to the CORE and this matches the interoperability reached when reaching the CORE. Overall this is the Computerized Organization to Realize the Ecosystem (CORE). "


Components of the Clinical Knowledge Ecosystem including evidence, guidance, action, and data.Image Modified


Full Deck from Alper/COKA is here - above is slide 7 from this deck. (see Assistive Technology Disclaimer)

6. Mary Butler/UMN-EPC Ecosystem Diagram  


Coordination and support in the center, surrounded by elements of the EPC evidence ecosystem working together.Image Modified 

JO Notes on this EPC diagram - are there opportunities to:

  • tie 'topic nomination' more closely to care transformation initiatives (e.g., as in ACTS COVID Guidance to Action Collaborative)? (currently there can be open nominations, but typically nominations only proceed if there is an 'adoption partner'; growing attention to feeding LHS efforts)
  • leverage standards more fully to improve FAIRness of information flowing into reviews and applying reviews more seamlessly to guidance/CDS/eCQM development? e.g., as outlined in table at top of this page. (SRDR/EPCs and others working on this)
  • tighten connections/collaborations between 'NextGen' offerings (more computable/concise/user-friendly/interactive evidence summaries) and those who can benefit from integrating that information into guidance and CDS offerings downstream? (there's important application nuance in the reports)
  • otherwise more tightly integrate the EPC/SRDR products and processes with broader efforts (e.g., ACTS COVID Guidance to Action Collaborative and other related efforts) in mutually beneficial ways?